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West Virginia rates for HCPCS A5054

Ostomy pouch, closed; for use on barrier with flange (two piece), each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.39 / $1.39 / $1.39
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.39 / $1.54 / $1.70
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.63 / $3.14 / $4.38
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.63 / $1.76 / $3.01
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.51 / $1.60 / $2.94
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.28 / $1.51 / $12.15
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.50 / $1.50 / $1.50
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.91 / $1.25 / $2.09